NPIMap

Organization Active NPI

Integrative Psychological and Social Services

  • Mental Health Counselor
  • Marysville, WA
National Provider Identifier
1114344074
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60412214 Issued in WA
Legal business name
INTEGRATIVE PSYCHOLOGICAL AND SOCIAL SERVICES
Practice address
5019 Grove St
Suite 102
Marysville, WA 98270-4487
Phone
(360) 348-0205
Fax
(360) 691-9887
NPI assigned
Mar 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Nicole C Winters, LICSW, PSYD
Title
Executive Director
Phone
(360) 348-0205

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X MC60425258 WA
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LH60412214 WA Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PY60195906 WA

Addresses

Primary practice location

5019 Grove St
Suite 102
Marysville, WA 98270-4487

Mailing address

5019 Grove St
Suite 102
Marysville, WA 98270
Phone (360) 348-0205

National Provider Directory

National Provider Directory
Tax ID family
Integrative Psychological and Social Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395878400000",
    "number": "1114344074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5019 GROVE ST",
            "address_2": "SUITE 102",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "98270",
            "telephone_number": "360-348-0205",
            "fax_number": "360-691-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5019 GROVE ST",
            "address_2": "SUITE 102",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704487",
            "telephone_number": "360-348-0205",
            "fax_number": "360-691-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE PSYCHOLOGICAL AND SOCIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-27",
        "last_updated": "2014-03-27",
        "status": "A",
        "authorized_official_last_name": "WINTERS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-348-0205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LICSW, PSYD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "WA",
            "license": "MC60425258",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60412214",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60195906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.